{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T22:11:12Z","timestamp":1793916672452,"version":"4.8.0"},"reference-count":24,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:00:00Z","timestamp":1747180800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["094073\/Z\/10\/B"],"award-info":[{"award-number":["094073\/Z\/10\/B"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["084344"],"award-info":[{"award-number":["084344"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["107743\/Z\/15\/Z"],"award-info":[{"award-number":["107743\/Z\/15\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100018956","name":"NIHR Cambridge Biomedical Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100018956","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Eclampsia is a life\u2010threatening complication of pre\u2010eclampsia. There are currently no means of reliably identifying women with pre\u2010eclampsia who are at the highest risk of progression to eclampsia and would thus benefit from prioritization for intensive monitoring and urgent delivery. This is particularly challenging in obstetric settings where resources are limited. We identify risk factors for the progression of pre\u2010eclampsia to eclampsia in low\u2010 and middle\u2010income settings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>Women diagnosed with pre\u2010eclampsia were prospectively recruited at a single tertiary referral centre in urban Uganda (2011\u20132016). Multivariable logistic regression models were used to identify risk factors that predicted the likelihood of progression to eclampsia. Key findings were validated in a geographically, socioeconomically, and ethnically distinct population using population\u2010wide hospital admission data from Ecuador (2021\u20132023).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In urban Uganda, progression from pre\u2010eclampsia to eclampsia was associated with nulliparity (OR 2.4; 95% CI: 1.1\u20135.4, <jats:italic>p<\/jats:italic>\u2009=\u20090.03), Baganda ethnicity (OR 1.9; 95% CI: 1.1\u20133.9, <jats:italic>p<\/jats:italic>\u2009=\u20090.01), unskilled\/unemployed paternal occupation (OR 2.8; 95% CI: 1.3\u20136.4, <jats:italic>p<\/jats:italic>\u2009=\u20090.03), and a trend toward younger maternal age (OR 0.9; 95% CI: 0.9\u20131.0 per year; <jats:italic>p<\/jats:italic>\u2009=\u20090.09). Risk of progression to eclampsia was not related to the severity of pre\u2010eclampsia or the number of antenatal clinic visits. In Ecuador, population\u2010wide analysis showed that progression to eclampsia was associated with younger maternal age (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and a trend toward public vs privately funded obstetric care (<jats:italic>p<\/jats:italic>\u2009=\u20090.09).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Eclampsia risk extends beyond clinical markers of pre\u2010eclampsia severity, with socioeconomic factors and maternal age playing crucial roles in disease progression. A targeted, context\u2010specific approach prioritizing high\u2010risk young women with socioeconomic vulnerabilities could optimize healthcare resources and mitigate severe hypertensive disorder risks.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.15154","type":"journal-article","created":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T09:23:29Z","timestamp":1747214609000},"page":"1487-1495","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Risk factors associated with progression from pre\u2010eclampsia to eclampsia: A prospective cohort study and population\u2010wide data analysis"],"prefix":"10.1111","volume":"104","author":[{"given":"Annettee","family":"Nakimuli","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology Makerere University and Mulago National Referral Hospital  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0507-3105","authenticated-orcid":false,"given":"Brittany A.","family":"Jasper","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Cambridge, The Rosie Hospital and NIHR Cambridge Biomedical Research Centre  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Nakubulwa","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Makerere University and Mulago National Referral Hospital  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moses","family":"Adroma","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Makerere University and Mulago National Referral Hospital  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jackline","family":"Akello","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Makerere University and Mulago National Referral Hospital  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imelda","family":"Namagembe","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Makerere University and Mulago National Referral Hospital  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Musa","family":"Sekikubo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Makerere University and Mulago National Referral Hospital  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eve","family":"Nakabembe","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Makerere University and Mulago National Referral Hospital  Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Moffett","sequence":"additional","affiliation":[{"name":"Department of Pathology and Centre for Trophoblast Research University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine E.","family":"Aiken","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Cambridge, The Rosie Hospital and NIHR Cambridge Biomedical Research Centre  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,14]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(14)70227-X"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)32609-5"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2020.04.00"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2013.10.879"},{"key":"e_1_2_13_6_1","first-page":"2012","volume-title":"Kampala, Uganda","author":"Uganda Bureau of Statistics (UBOS) and ICF International Inc. Uganda Demographic and Health Survey","year":"2011"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68397-9"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-023-00417-6"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2020.09.047"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12629"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2020.09.037"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.118.11513"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2023.1144170"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000437382.03963.88"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.116.08706"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60932-6"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-016-0804-4"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.2147\/IJWH.S131934"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.7860\/JCDR\/2016\/21078.8499"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000696"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/ncpneph0035"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0091198"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgph.0000545"},{"issue":"1","key":"e_1_2_13_24_1","first-page":"71","article-title":"\u201cNot a boy, not a child\u201d: a qualitative study on young people's views on childbearing in Uganda","volume":"14","author":"Beyeza\u2010Kashesya J","year":"2010","journal-title":"Afr J Reprod Health"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0968-8080(03)02176-1"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.15154","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T01:10:59Z","timestamp":1753233059000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.15154"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,14]]},"references-count":24,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1111\/aogs.15154"],"URL":"https:\/\/doi.org\/10.1111\/aogs.15154","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,14]]},"assertion":[{"value":"2025-04-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}